Ostomy closure rate during COVID-19 pandemic: an Italian multicentre observational study.
Colostomy
Corona virus disease 2019 (COVID-19)
Cost
Ileostomy
Ostomy
Quality of life (QoL)
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Journal
Updates in surgery
ISSN: 2038-3312
Titre abrégé: Updates Surg
Pays: Italy
ID NLM: 101539818
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
21
01
2022
accepted:
04
03
2022
pubmed:
25
3
2022
medline:
24
6
2022
entrez:
24
3
2022
Statut:
ppublish
Résumé
During the corona virus disease 2019 (COVID-19) pandemic, most of the surgical procedures were performed for emergencies or oncologic reasons to the detriment of the remaining elective procedures for benign conditions. Ileostomy or colostomy creation are sequelae of oncologic or emergency colorectal surgery, but their closure does not fall within the definition of oncologic or emergency surgery. The aim of this retrospective multicentre observational study is to report the impact of COVID-19 pandemic on the ostomy closure rate in Italy. Data regarding ileostomy and colostomy creation and closure from 24 Italian centres, during the study period (March 2020-February 2021) and during the control period (March 2019-February 2020) were collected. Three hospitals (12.5%) were COVID free. The number of colostomies and ileostomies created and closed in the same period was lower ( -18.8% and -30%, respectively) in the study period in comparison to the control period (p = 0.1915 and p = 0.0001, respectively), such as the ostomies closed in the analysed periods but created before (colostomy -36.2% and ileostomy -7.4%, p = 0.2211 and p = 0.1319, respectively). Overall, a 19.5% reduction in ostomies closed occurred in the study period. Based on the present study, a reduction in ostomy closure rate occurred in Italy between March 2020 and February 2021. During the pandemic, the need to change the clinical practice probably prolonged deterioration of quality of life in patients with ostomies, increasing number of stomas that will never be closed, and related management costs, even if these issues have not been investigated in this study.
Identifiants
pubmed: 35322388
doi: 10.1007/s13304-022-01274-w
pii: 10.1007/s13304-022-01274-w
pmc: PMC8942758
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1017-1025Investigateurs
Laura Agostinelli
(L)
Ferdinando Agresta
(F)
Gabriele Anania
(G)
Laura Antolino
(L)
Pietro Anoldo
(P)
Emanuele Botteri
(E)
Umberto Bracale
(U)
Fabio Carbone
(F)
Massimo Carlini
(M)
Francesco Maria Carrano
(FM)
Giorgia Casadei
(G)
Diego Coletta
(D)
Francesco Crafa
(F)
Nicola de'Angelis
(N)
Paolo Delrio
(P)
Giovanni Domenico De Palma
(GD)
Marcello Di Martino
(M)
Ugo Elmore
(U)
Lorenzo Gozzini
(L)
Michele Grieco
(M)
Giovanni Battista Levi Sandri
(GB)
Edelweiss Licitra
(E)
Andrea Lucchi
(A)
Marco Massani
(M)
Riccardo Memeo
(R)
Marco Milone
(M)
Dario Oppici
(D)
Monica Ortenzi
(M)
Alberto Patriti
(A)
Francesca Pecchini
(F)
Roberto Peltrini
(R)
Micaela Piccoli
(M)
Adolfo Pisanu
(A)
Mauro Podda
(M)
Gilberto Poggioli
(G)
Maria Chiara Ranucci
(MC)
Daniela Rega
(D)
Riccardo Rosati
(R)
Francesco Roscio
(F)
Matteo Rottoli
(M)
Roberto Santoro
(R)
Alberto Sartori
(A)
Antonino Spinelli
(A)
Serafino Vanella
(S)
Giovanni Vennarecci
(G)
Nereo Vettoretto
(N)
Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2022. Italian Society of Surgery (SIC).
Références
Bracale U, Podda M, Castiglioni S, Peltrini R, Sartori A, Arezzo A, Corcione F, Agresta F (2021) Changes in surgicaL behaviOrs dUring the CoviD-19 pandemic. The SICE CLOUD19 Study. Updates Surg. 73(2):731–744. https://doi.org/10.1007/s13304-021-01010-w
doi: 10.1007/s13304-021-01010-w
pubmed: 33656697
pmcid: 7926077
Morales-Conde S, Balla A, Álvarez Gallego M, Aranda Narváez JM, Badia JM, Balibrea JM, García-Botella A, Guirao X, Espín-Basany E, Martín-Antona E, Pérez EM, Martínez Cortijo S, Pascual Miguelañez I, Pérez Díaz L, Ramos Rodríguez JL, Rubio Pérez I, Sánchez Santos R, Soria-Aledo V (2020) A dynamic scale for surgical activity (DYSSA) stratification during the COVID-19 pandemic. Br J Surg. 107(10):e425–e426. https://doi.org/10.1002/bjs.11870
doi: 10.1002/bjs.11870
pubmed: 32735347
pmcid: 7929180
Nunoo-Mensah JW, Rizk M, Caushaj PF, Giordano P, Fortunato R, Dulskas A, Bugra D, da Costa Pereira JM, Escalante R, Koda K, Samalavicius NE, Maeda K, Chun HK, ISUCRS COVID-19 Participating Investigator Group (2020) COVID-19 and the global impact on colorectal practice and surgery. Clin Colorectal Cancer. 19(3):178-190.e1. https://doi.org/10.1016/j.clcc.2020.05.011
doi: 10.1016/j.clcc.2020.05.011
pubmed: 32653470
pmcid: 7276135
Bellato V, Konishi T, Pellino G, An Y, Piciocchi A, Sensi B, Siragusa L, Khanna K, Pirozzi BM, Franceschilli M, Campanelli M, Efetov S, Sica GS (2020) Screening policies, preventive measures and in-hospital infection of COVID-19 in global surgical practices. J Glob Health. 10(2):020507. https://doi.org/10.7189/jogh.10.020507
doi: 10.7189/jogh.10.020507
pubmed: 33110590
pmcid: 7567431
Reichert M, Sartelli M, Weigand MA, Doppstadt C, Hecker M, Reinisch-Liese A, Bender F, Askevold I, Padberg W, Coccolini F, Catena F, Hecker A, WSES COVID-19 Emergency Surgery Survey Collaboration Group (2020) Impact of the SARS-CoV-2 pandemic on emergency surgery services-a multi-national survey among WSES members. World J Emerg Surg. 15(1):64. https://doi.org/10.1186/s13017-020-00341-0
doi: 10.1186/s13017-020-00341-0
pubmed: 33298131
pmcid: 7724441
Gundavda MK, Gundavda KK (2020) Cancer or COVID-19? A review of guidelines for safe cancer care in the wake of the pandemic. SN Compr Clin Med. 21:1–11. https://doi.org/10.1007/s42399-020-00632-2
doi: 10.1007/s42399-020-00632-2
Moletta L, Pierobon ES, Capovilla G, Costantini M, Salvador R, Merigliano S, Valmasoni M (2020) International guidelines and recommendations for surgery during Covid-19 pandemic: a systematic review. Int J Surg. 79:180–188. https://doi.org/10.1016/j.ijsu.2020.05.061
doi: 10.1016/j.ijsu.2020.05.061
pubmed: 32454253
pmcid: 7245259
Coimbra R, Edwards S, Kurihara H, Bass GA, Balogh ZJ, Tilsed J, Faccincani R, Carlucci M, Martínez Casas I, Gaarder C, Tabuenca A, Coimbra BC, Marzi I (2020) European society of trauma and emergency surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. Eur J Trauma Emerg Surg. 46(3):505–510. https://doi.org/10.1007/s00068-020-01364-7
doi: 10.1007/s00068-020-01364-7
pubmed: 32303798
Francis N, Dort J, Cho E, Feldman L, Keller D, Lim R, Mikami D, Phillips E, Spaniolas K, Tsuda S, Wasco K, Arulampalam T, Sheraz M, Morales S, Pietrabissa A, Asbun H, Pryor A (2020) SAGES and EAES recommendations for minimally invasive surgery during COVID-19 pandemic. Surg Endosc 34(6):2327–2331. https://doi.org/10.1007/s00464-020-07565-w
doi: 10.1007/s00464-020-07565-w
pubmed: 32323016
Shabbir A, Menon RK, Somani J, So JBY, Ozman M, Chiu PWY, Lomanto D (2020) ELSA recommendations for minimally invasive surgery during a community spread pandemic: a centered approach in Asia from widespread to recovery phases. Surg Endosc. 34(8):3292–3297. https://doi.org/10.1007/s00464-020-07618-0
doi: 10.1007/s00464-020-07618-0
pubmed: 32394175
pmcid: 7212724
Stabilini C, East B, Fortelny R, Gillion JF, Lorenz R, Montgomery A, Morales-Conde S, Muysoms F, Pawlak M, Reinpold W, Simons M, de Beaux AC (2020) European Hernia Society (EHS) guidance for the management of adult patients with a hernia during the COVID-19 pandemic. Hernia. 24(5):977–983. https://doi.org/10.1007/s10029-020-02212-8
doi: 10.1007/s10029-020-02212-8
pubmed: 32415652
pmcid: 7227454
Remzi FH, Panis Y, Spinelli A, Kotze PG, Mantzaris G, Söderholm JD, d’Hoore A, Bemelman WA, Yamamoto T, Pemberton JH, Tiret E, Øresland T, Fleshner P (2020) International organization for the study of IBD recommendations for surgery in patients with IBD during the coronavirus disease 2019 pandemic. Dis Colon Rectum 63(7):870–873. https://doi.org/10.1097/DCR.0000000000001718
doi: 10.1097/DCR.0000000000001718
pubmed: 32355056
Morales-Conde S, Alarcón I, Yang T, Licardie E, Balla A (2020) A decalogue to avoid routine ileostomy in selected patients with border line risk to develop anastomotic leakage after minimally invasive low-anterior resection: a pilot study. Surg Innov 27(1):44–53. https://doi.org/10.1177/1553350619890720
doi: 10.1177/1553350619890720
pubmed: 31789117
Thoker M, Wani I, Parray FQ, Khan N, Mir SA, Thoker P (2014) Role of diversion ileostomy in low rectal cancer: a randomized controlled trial. Int J Surg 12(9):945–951. https://doi.org/10.1016/j.ijsu.2014.07.012
doi: 10.1016/j.ijsu.2014.07.012
pubmed: 25038542
Messaris E, Sehgal R, Deiling S, Koltun WA, Stewart D, McKenna K, Poritz LS (2012) Dehydration is the most common indication for readmission after diverting ileostomy creation. Dis Colon Rectum. 55(2):175–80. https://doi.org/10.1097/DCR.0b013e31823d0ec5
doi: 10.1097/DCR.0b013e31823d0ec5
pubmed: 22228161
Ozturk E, Kiran RP, Remzi F, Fazio VW (2009) Early readmission after ileoanal pouch surgery. Dis Colon Rectum. 52(11):1848–53. https://doi.org/10.1007/DCR.0b013e3181b15610
doi: 10.1007/DCR.0b013e3181b15610
pubmed: 19966631
Zenger S, Gurbuz B, Can U, Balik E, Yalti T, Bugra D (2021) Comparative study between ghost ileostomy and defunctioning ileostomy in terms of morbidity and cost-effectiveness in low anterior resection for rectal cancer. Langenbecks Arch Surg. 406(2):339–347. https://doi.org/10.1007/s00423-021-02089-w
doi: 10.1007/s00423-021-02089-w
pubmed: 33537875
Koperna T (2003) Cost-effectiveness of defunctioning stomas in low anterior resections for rectal cancer: a call for benchmarking. Arch Surg. 138(12):1334–8. https://doi.org/10.1001/archsurg.138.12.1334
doi: 10.1001/archsurg.138.12.1334
pubmed: 14662534
Code of Conduct for responsible Research. World Health Organization (WHO). 2017. https://www.who.int/about/ethics/code-of-conduct-responsible-research.pdf .
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Bull World Health Organ. 85(11):867–72. https://doi.org/10.2471/blt.07.045120
doi: 10.2471/blt.07.045120
Bernardi L, Germani P, Del Zotto G, Scotton G, de Manzini N (2020) Impact of COVID-19 pandemic on general surgery training program: an Italian experience. Am J Surg. 220(5):1361–1363. https://doi.org/10.1016/j.amjsurg.2020.06.010
doi: 10.1016/j.amjsurg.2020.06.010
pubmed: 32564874
pmcid: 7287477
Ourô S, Ferreira MP, Albergaria D, Maio R (2021) Loop ileostomy in rectal cancer surgery: factors predicting reversal and stoma related morbidity. Langenbecks Arch Surg. 406(3):843–853. https://doi.org/10.1007/s00423-021-02169-x
doi: 10.1007/s00423-021-02169-x
pubmed: 33851240
Gustafsson CP, Gunnarsson U, Dahlstrand U, Lindforss U (2018) Loop-ileostomy reversal-patient-related characteristics influencing time to closure. Int J Colorectal Dis. 33(5):593–600. https://doi.org/10.1007/s00384-018-2994-x
doi: 10.1007/s00384-018-2994-x
pubmed: 29508050
pmcid: 5899111
Kaidar-Person O, Person B, Wexner SD (2005) Complications of construction and closure of temporary loop ileostomy. J Am Coll Surg. 201(5):759–73. https://doi.org/10.1016/j.jamcollsurg.2005.06.002
doi: 10.1016/j.jamcollsurg.2005.06.002
pubmed: 16256921
Ahmad NZ, Abbas MH, Khan SU, Parvaiz A (2021) A meta-analysis of the role of diverting ileostomy after rectal cancer surgery. Int J Colorectal Dis. 36(3):445–455. https://doi.org/10.1007/s00384-020-03771-z
doi: 10.1007/s00384-020-03771-z
pubmed: 33064212
Liu C, Bhat S, Sharma P, Yuan L, O’Grady G, Bissett I (2021) Risk factors for readmission with dehydration after ileostomy formation: a systematic review and meta-analysis. Colorect Dis. 23(5):1071–1082. https://doi.org/10.1111/codi.15566
doi: 10.1111/codi.15566
Borucki JP, Schlaeger S, Crane J, Hernon JM, Stearns AT (2021) Risk and consequences of dehydration following colorectal cancer resection with diverting ileostomy. A systematic review and meta-analysis. Colorect Dis. 23(7):1721–1732. https://doi.org/10.1111/codi.15654
doi: 10.1111/codi.15654
Pata F, Bondurri A, Ferrara F, Parini D, Rizzo G, Multidisciplinary Italian Study group for STOmas (MISSTO) (2020) Enteral stoma care during the COVID-19 pandemic: practical advice. Colorect Dis. 22(9):985–992. https://doi.org/10.1111/codi.15279
doi: 10.1111/codi.15279
Cavaliere D, Parini D, Marano L, Cipriani F, Di Marzo F, Macrì A, D’Ugo D, Roviello F, Gronchi A, SICO (Italian Society of Surgical Oncology) (2021) Surgical management of oncologic patient during and after the COVID-19 outbreak: practical recommendations from the Italian society of Surgical Oncology. Updates Surg. 73(1):321–329. https://doi.org/10.1007/s13304-020-00921-4
doi: 10.1007/s13304-020-00921-4
pubmed: 33184782
Zhang L, Zheng W, Cui J, Wu YL, Xu TL, Zhang HZ (2020) Risk factors for nonclosure of defunctioning stoma and stoma-related complications among low rectal cancer patients after sphincter-preserving surgery. Chronic Dis Transl Med. 6(3):188–197. https://doi.org/10.1016/j.cdtm.2020.02.004
doi: 10.1016/j.cdtm.2020.02.004
pubmed: 32908969
pmcid: 7451586
Back E, Häggström J, Holmgren K, Haapamäki MM, Matthiessen P, Rutegård J, Rutegård M (2021) Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables. Br J Surg. https://doi.org/10.1093/bjs/znab260
doi: 10.1093/bjs/znab260
pubmed: 34508549
D’Ambrosio G, Paganini AM, Balla A, Quaresima S, Ursi P, Bruzzone P, Picchetto A, Mattei FI, Lezoche E (2016) Quality of life in non-early rectal cancer treated by neoadjuvant radio-chemotherapy and endoluminal loco-regional resection (ELRR) by transanal endoscopic microsurgery (TEM) versus laparoscopic total mesorectal excision. Surg Endosc. 30(2):504–511. https://doi.org/10.1007/s00464-015-4232-8
doi: 10.1007/s00464-015-4232-8
pubmed: 26045097
Farag S, Rehman S, Sains P, Baig MK, Sajid MS (2017) Early vs delayed closure of loop defunctioning ileostomy in patients undergoing distal colorectal resections: an integrated systematic review and meta-analysis of published randomized controlled trials. Colorectal Dis. 19(12):1050–1057. https://doi.org/10.1111/codi.13922
doi: 10.1111/codi.13922
pubmed: 29028289
Gadan S, Brand JS, Rutegård M, Matthiessen P (2021) Defunctioning stoma and short- and long-term outcomes after low anterior resection for rectal cancer—a nationwide register-based cohort study. Int J Colorectal Dis. 36(7):1433–1442. https://doi.org/10.1007/s00384-021-03877-y
doi: 10.1007/s00384-021-03877-y
pubmed: 33728534
pmcid: 8195973
Pisarska M, Gajewska N, Małczak P, Wysocki M, Witowski J, Torbicz G, Major P, Mizera M, Dembiński M, Migaczewski M, Budzyński A, Pędziwiatr M (2018) Defunctioning ileostomy reduces leakage rate in rectal cancer surgery—systematic review and meta-analysis. Oncotarget. 9(29):20816–20825. https://doi.org/10.18632/oncotarget.25015
doi: 10.18632/oncotarget.25015
pubmed: 29755692
pmcid: 5945534
Tan WS, Tang CL, Shi L, Eu KW (2009) Meta-analysis of defunctioning stomas in low anterior resection for rectal cancer. Br J Surg. 96(5):462–72. https://doi.org/10.1002/bjs.6594
doi: 10.1002/bjs.6594
pubmed: 19358171
den Dulk M, Marijnen CA, Collette L, Putter H, Påhlman L, Folkesson J, Bosset JF, Rödel C, Bujko K, van de Velde CJ (2009) Multicentre analysis of oncological and survival outcomes following anastomotic leakage after rectal cancer surgery. Br J Surg. 96(9):1066–75. https://doi.org/10.1002/bjs.6694
doi: 10.1002/bjs.6694
Lezoche E, Fabiani B, D’Ambrosio G, Ursi P, Balla A, Lezoche G, Monteleone F, Paganini AM (2013) Nucleotide-guided mesorectal excision combined with endoluminal locoregional resection by transanal endoscopic microsurgery in the treatment of rectal tumors: technique and preliminary results. Surg Endosc. 27(11):4136–41. https://doi.org/10.1007/s00464-013-3012-6
doi: 10.1007/s00464-013-3012-6
pubmed: 23708724
Matthiessen P, Hallböök O, Rutegård J, Simert G, Sjödahl R (2007) Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial. Ann Surg. 246(2):207–14. https://doi.org/10.1097/SLA.0b013e3180603024
doi: 10.1097/SLA.0b013e3180603024
pubmed: 17667498
pmcid: 1933561
Chambers WM, Mortensen NJ (2004) Postoperative leakage and abscess formation after colorectal surgery. Best Pract Res Clin Gastroenterol. 18(5):865–80. https://doi.org/10.1016/j.bpg.2004.06.026
doi: 10.1016/j.bpg.2004.06.026
pubmed: 15494283
Phan K, Oh L, Ctercteko G, Pathma-Nathan N, El Khoury T, Azam H, Wright D, Toh JWT (2019) Does a stoma reduce the risk of anastomotic leak and need for re-operation following low anterior resection for rectal cancer: systematic review and meta-analysis of randomized controlled trials. J Gastrointest Oncol. 10(2):179–187. https://doi.org/10.21037/jgo.2018.11.07
doi: 10.21037/jgo.2018.11.07
pubmed: 31032083
pmcid: 6465490
Ng ZQ, Levitt M, Platell C (2020) The feasibility and safety of early ileostomy reversal: a systematic review and meta-analysis. ANZ J Surg. 90(9):1580–1587. https://doi.org/10.1111/ans.16079
doi: 10.1111/ans.16079
pubmed: 32597018
Park J, Angenete E, Bock D, Correa-Marinez A, Danielsen AK, Gehrman J, Haglind E, Jansen JE, Skullman S, Wedin A, Rosenberg J (2020) Cost analysis in a randomized trial of early closure of a temporary ileostomy after rectal resection for cancer (EASY trial). Surg Endosc. 34(1):69–76. https://doi.org/10.1007/s00464-019-06732-y
doi: 10.1007/s00464-019-06732-y
pubmed: 30911920
Hacim NA, Akbas A, Meric S, Altinel Y, Karabay O, Yavuz E (2020) Diverting ileostomy duration is the main determinant of ileostomy-related complications after surgical treatment of rectum cancer. J Oncol. 2020:4186857. https://doi.org/10.1155/2020/4186857
doi: 10.1155/2020/4186857
pubmed: 32322269
pmcid: 7166299
Wang L, Chen X, Liao C, Wu Q, Luo H, Yi F, Wei Y, Zhang W (2021) Early versus late closure of temporary ileostomy after rectal cancer surgery: a meta-analysis. Surg Today. 51(4):463–471. https://doi.org/10.1007/s00595-020-02115-2
doi: 10.1007/s00595-020-02115-2
pubmed: 32833059
Vogel I, Reeves N, Tanis PJ, Bemelman WA, Torkington J, Hompes R, Cornish JA (2021) Impact of a defunctioning ileostomy and time to stoma closure on bowel function after low anterior resection for rectal cancer: a systematic review and meta-analysis. Tech Coloproctol. 25(7):751–760. https://doi.org/10.1007/s10151-021-02436-5
doi: 10.1007/s10151-021-02436-5
pubmed: 33792822
pmcid: 8187190
Garfinkle R, Savage P, Boutros M, Landry T, Reynier P, Morin N, Vasilevsky CA, Filion KB (2019) Incidence and predictors of postoperative ileus after loop ileostomy closure: a systematic review and meta-analysis. Surg Endosc. 33(8):2430–2443. https://doi.org/10.1007/s00464-019-06794-y
doi: 10.1007/s00464-019-06794-y
pubmed: 31020433
Clausen FB, Dohrn N, Hölmich ER, Klein M, Gögenur I (2021) Safety of early ileostomy closure: a systematic review and meta-analysis of randomized controlled trials. Int J Colorectal Dis 36(2):203–212. https://doi.org/10.1007/s00384-020-03761-1
doi: 10.1007/s00384-020-03761-1
pubmed: 32970178
Vogel I, Vaughan-Shaw PG, Gash K, Withers KL, Carolan-Rees G, Thornton M, Dhruvao Rao PK, Torkington J, Cornish JA (2021) Improving the time to ileostomy closure following an anterior resection for rectal cancer in the UK. Colorectal Dis. https://doi.org/10.1111/codi.15921
doi: 10.1111/codi.15921
pubmed: 34543512
pmcid: 8250723